PDCM Reference Materials

Resources: 

Training Tools

• The Basics of Team-Based Care Billing and Coding PowerPoint 
  Designed for billing SMEs and PO leaders to promote and educate practice staff and revenue cycle team members on the basics of team-based care billing and coding.
• BCBSM PDCM Billing Description of Codes, May 2020 Webinar
• PDCM Specialty Oncology-Focused Billing Webinar

Billing Resources

• PDCM Commercial and MA Billing Guidelines
• Scope of Service for Unlicensed Care Team Members
  As a general PDCM guideline, all participants should operate within their scope of practice and clearly document services provided, including information to support the medical necessity of the service. This sample standing agreement may vary based upon organizational structure and can be used as a guide in developing the particular agreement for each practice and/or organization. 
  • View Scope of Service Sample
• Groups Not Participating in PDCM (Excel Spreadsheet)
• BCN and BCN Advantage℠ PDCM FAQs (PDF)
• Multipayer Table: BCBSM PDCM and Priority Health (PDF)
• Medicare Learning Network Chronic Care Management CCM Fact Sheet (Updated March 2022)
• Medicare Learning Network Transitional Care Management Services (PDF) (Updated August 2022)